Endoscopy 2018; 50(04): S131
DOI: 10.1055/s-0038-1637422
ESGE Days 2018 ePoster Podium presentations
21.04.2018 – GI tumors
Georg Thieme Verlag KG Stuttgart · New York

OCCURRENCE OF GASTRIC PRECANCEROUS CONDITIONS IN A NATION-WIDE CONSECUTIVE ENDOSCOPIC POPULATION PRESENTING WITH UPPER GASTROINTESTINAL SYMPTOMS

E Lahner
1   Sapienza University, Rome, Italy
,
M Carabotti
1   Sapienza University, Rome, Italy
,
G Esposito
1   Sapienza University, Rome, Italy
,
C Hassan
2   Gastroenterology and Digestive Endoscopy, ‘Nuovo Regina Margherita’ Hospital, Rome, Italy
,
A Zullo
2   Gastroenterology and Digestive Endoscopy, ‘Nuovo Regina Margherita’ Hospital, Rome, Italy
,
B Annibale
1   Sapienza University, Rome, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

Metaplastic atrophic (MAG) and autoimmune gastritis (AIG) predispose to gastric neoplasias, but are mainly clinically silent. This study aimed to assess MAG occurrence in an endoscopic population with upper-GI-symptoms.

Methods:

Post-hoc-study on endoscopic-histological data from 668 consecutive adults (age 58yrs) with upper-GI-symptoms, obtained from a prospective-multicenter-study.

Pts with dyspepsia (46%), reflux (22%) and both (32%) as indication for esophagogastroduodenoscopy (EGD) were included. Pts underwent EGD with 5 biopsies according to Sydney System.

Results:

In 201 (30.1%) pts, MAG was detected, Hp positive in 41.5%. OLGA stages 1, 2, 3, and 4 were found in 20.8%, 6.7%, 1.5%, and 0.4%. In 61 (9.1%) of patients, corporal MAG was found, Hp-positive in 33%, which was limited to corporal mucosa with spared-antrum (AIG) in 37 (5.5%).

In MAG pts, dyspepsia, reflux or both were present in 48%, 18%, and 33%, similar as in those without MAG. Features associated with MAG were age> 55yrs (OR 1.8, 95% CI 1.2 – 2.6), active Hp (OR 1.7, 95% CI 1.2 – 2.4), smoking (OR 1.6, 95% CI 1.1 – 2.3).

The histological picture of AIG was associated with dyspepsia (67.6% pts, OR 2.4,95% CI 1.2 – 4.9), while other features (age, gender, BMI, smoking or Hp) had no role.

Conclusions:

MAG, a condition at increased gastric cancer risk, is detected in 1/3 pts presenting with upper-GI-symptoms to EGD performed according to Sydney system, is associated with age> 55 years, active Hp infection and smoking, but may present indifferently with reflux or dyspeptic symptoms. Dyspepsia is associated with AIG regardless of age and Hp. These data support the need of high-quality EGD with biopsies in pts presenting with upper-GI-symptoms to diagnose potential gastric precancerous conditions.